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MRI and US Fusion Guided Biopsy of the Prostate: Care Instructions

MRI and US Fusion Guided Biopsy of the Prostate

Care Instructions

Why is this test done?

A biopsy is a procedure that takes a sample of tissue for study. The most common reason is to look for cancer.

The prostate gland is part of the male reproductive system. It produces a fluid that makes up most of what’s in semen.

What is magnetic resonance imaging (MRI) and ultrasound (US) fusion guided prostate biopsy?

Using advanced biopsy equipment the MRI combines with ultrasound images to identify specific areas for biopsy of the prostate.

A prostate biopsy is done with a biopsy needle. This needle can be placed more accurately to get samples for testing with the help of the combined images.

Who should have this type of prostate biopsy?

This procedure is usually done if:

  • you have a high or rising prostate-specific antigen (PSA) level
  • your healthcare provider thinks that you may have prostate cancer
  • you’ve had an abnormal rectal exam
  • you’ve had abnormal findings on prostate MRI
  • your genes put you at more risk to develop prostate problems
  • you’re being monitored for prostate cancer

What are the benefits?

Some abnormal tissue growths (called tumours) that can grow in your prostate are clinically insignificant. This means that they don’t need any immediate treatment. They aren’t likely to pose a threat to your health.

Using the MRI image to guide your biopsy helps raise the chance of finding prostate tumours that need treatment.

MRI images give precise information. This lowers the chance that a serious tumour will be missed, which can happen with a regular ultrasound biopsy.

This type of test causes less tissue damage. You’ll usually have a shorter recovery to get back to your daily activities.

What are the risks?

After this procedure you may have:

  • difficulty passing your urine – in rare cases, you may need a temporary urinary catheter

  • bleeding in your stool, urine, and semen

  • infection in the blood or urine

  • pain (usually very little)

  • allergic reaction

Getting ready for your procedure


  • Get your bloodwork for creatinine level done at least 6 weeks before your MRI appointment.

  • The MRI will be done at least 1 week before your biopsy.

  • The diagnostic imaging department will call you to confirm your instructions 48 hours before your appointment.

  • You’ll be asked to use an enema the night before and the morning of the MRI. It’s important that your bowels are empty.

  • Only have clear liquids after dinner the night before your MRI.

Fusion biopsy procedure

  • Your urine may be tested to see if you have a urinary tract infection. If you have a urinary tract infection, your prostate biopsy may be postponed while you take antibiotics to clear the infection.

  • Follow the instructions you get to stop taking medicines before the procedure that can put you at higher risk of bleeding. This includes medicines such as warfarin (Coumadin), clopidegrel (Plavix ), iveroxaban (Xarelto), Aspirin, ibuprofen (Advil, Motrin), and certain herbal supplements. Talk about any blood thinners you take with your urologist. Take all other medicines as normal.

  • Do a cleansing enema at home before your biopsy procedure.

  • You can have a light breakfast the day of the procedure.

  • Take the antibiotics you were prescribed 1 to 2 hours before your prostate biopsy. This helps to prevent infection from the procedure.

What happens during the procedure?

MRI/US fusion guided prostate biopsy is usually done in the outpatient procedure area. The MRI and ultrasound images help guide where the biopsy needle is put in.

You’ll be asked to lay on your left side. The doctor will examine your prostate again. A lubricated ultrasound probe is then placed into your rectum. The ultrasound scan of your prostate is done. The doctor will see that image on the screen.

You may feel some discomfort or mild pain when the ultrasound probe is put into your rectum. Local anesthesia (numbing medicine) is used to ease the discomfort.

The biopsy (tissue sample) is taken using a needle and then sent to the lab for analysis.

What will happen after?

It’s common to have rectal pain or discomfort for a few days.

Biopsy results should be available about 2 weeks after your procedure. You’ll have a follow-up appointment with your urologist.

Go back to your regular physical activities as your pain level allows. Follow the instructions about activity and take pain medicine, if needed, as prescribed.

Post-procedure care

  • Take your antibiotics as prescribed.

  • Don’t take any anti-inflammatory medicines such as ibuprofen (Advil, Motrin) for about 1 week after your biopsy. Your urologist will let you know when you can start taking this type of medicine again.

  • You may see blood in your urine, stool, or semen for up to 6 to 8 weeks.

  • If you have pain, sit in a tub of warm water and take acetaminophen (Tylenol) as prescribed.

  • Go back to eating your regular diet after your biopsy. Avoid drinks with caffeine or alcohol, and don’t have spicy foods that may irritate the biopsy area.

  • Avoid strenuous exercise and sex for 2 days after your biopsy.

  • Call your doctor or go to Emergency if you have signs of infection such as:

    • fever greater than 38 °C

    • difficulty urinating

    • severe pain

    • heavy bleeding (more than a few drops or streaks)

If you have any concerns or questions about your procedure, call your doctor.

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Current as of: November 1, 2021

Author: Urology, Alberta Health Services

This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.